Dear Counsellor:

My 14-year-old son has been diagnosed with attention deficit hyperactivity disorder (ADHD) and learning disorder. I am in a state of panic as I don't know what to do.

- Maria

Dear Maria:

ADHD is usually diagnosed in childhood but sometimes the diagnosis is made during adolescence. Students with ADHD function better in classes which have few students. They need individual attention, which is not available in high school.

These students do well in prep school, but when they reach high school problems tend to arise. In high school, class sizes are large and there are several subjects to study. Their organisational skills are stretched beyond their limits and the students cannot cope without assistance.

needs supervision and organisation

Your son needs close supervision with homework and help with organising himself. He needs to make a study timetable as well as a homework schedule. He should not wait until the day before the homework is due to have it done. He should be studying all the time and homework should be done as soon as it is given. Organise a space at home for him with his books and writing tools.

Many students with ADHD also have anger problems and need social skills training. Please have his ears and eyes checked as visual and auditory impairment may worsen his disability. He will need to see a special educator to have his learning disorder assessed in detail. Medication for ADHD is helpful and you should discuss this with your psychiatrist. Some children are unable to tolerate the medication.

There is an ADHD support group for teachers and parents. It is held on the third Saturday in every month at the Stella Maris Centre in St Andrew.

Bed-wetting blues

Dear Counsellor:

My six-year-old son has been wetting his bed at nights since infancy. On some nights, he does not wet the bed. He gets depressed about this.

- Jennifer

Dear Jennifer:

Bed-wetting is a common problem and it runs in families. Many times the parents or relatives had similar problems. It is nothing to be ashamed of as many children have this problem. Children should not be punished as this is a medical problem.

One of the theories for bed-wetting is that the relevant brain centre is immature and with time the child will achieve complete dryness at night. Most children outgrow this problem spontaneously.

The other theory is that the child is sleeping deeply and the sensation of bladder fullness doesn't awaken him. The bladder has to be trained to accommodate large volumes of urine. Many children develop emotional and behavioural problems because of shame and guilt about the bed-wetting.

bladder training

One strategy to control bed-wetting is bladder training. Let your son drink a lot of fluids in the daytime and urinate infrequently. This is done so that the bladder gets used to holding large volumes of urine for long periods.

Fluid restriction is the other strategy. Your son has to abstain from drinking fluid late in the evening and pass urine before bedtime. Awaken him later on to pass urine. Reward him for dry nights to motivate and maintain success.

Medication can be given to cause dryness at nights. If there are emotional or behavioural issues, these should be dealt with by counselling, support and reassurance.

Remember that it is a common problem and he will outgrow it.

Email questions to Dr Yvonnie Bailey-Davidson at yvonniebd@hotmail.com or call her at 978-8602.